When Silverado was founded 28 years ago, the focus in assisted living was on helping residents with activities of daily living such as bathing, dressing and grooming, Loren Shook told those attending a session at the National Investment Center for Seniors Housing & Care’s 2024 Fall Conference in Washington, DC.
Now, the Silverado co-founder, president, CEO and chairman said, assisted living is “a whole different world … providing effective treatment to people in our communities.”
Providers are “creating and offering a brain-healthy environment,” Shook said. “We’re already improving people’s cognition, and I don’t think this industry even knows it.” Silverado and other assisted living providers, he added, also are slowing the progression of dementia.
Shook enumerated several developments in memory care that show promise.
“We have blood tests that are able to show if you have Alzheimer’s disease, Parkinson’s disease, Lewy body disease,” he said, adding that the tests are “very inexpensive” and “you can see that you’ve got it way before you have symptoms.”
Also, Shook said, research is showing that stimulating the olfactory system can result in growth in the hippocampus of the brain. “You just smell different things, and by doing that, you actually improve memory,” he said.
Shook said he is “pretty excited” about a new product coming out called Memory Air, “because it will give you 40 different scents during the night as you sleep. It’s about as simple as it gets.”
But the Silverado CEO said there are areas where providers can improve. One such area, he said, is staff training.
Untrained staff members who interact with residents living with dementia, Shook said, can inadvertently stimulate negative behavior in them, which can lead to preventable hospitalizations and medication use. Silverado’s training program, he added, has led to a reduction in emergency department visits, hospital admissions and rehospitalizations.
Panelist Kris Engskov, co-founder and CEO of specialty dementia care provider Rippl, said that dementia care requires a specialty approach. “We have got to invest in the clinical capability necessary to take care of these patients,” he told attendees. “You’ve got to have that ability at some level in your communities, and it can’t be marketing.”
Using evidence-based programming, Engskov added, “will help our businesses.”
“We have to get results, and that will open up lots of new opportunities, especially given the size of the market,” he said.
Assisted living providers, however, must be open to workflow changes, including virtual care, to be able to help residents age in place, Engskov said. “There will be way too many residents who need the care and far, far too few clinicians. So I think being flexible around how we deliver care in a community will make a very big difference,” he said.
Rogen documentary shown
The panel discussion followed a screening of “Taking Care,” a not-yet-released 38-minute documentary that provides a look at the struggles of Adele Miller and her family as Adele lived with Alzheimer’s and her family tried to care for her. Adele is the mother of screenwriter, director and producer Lauren Miller Rogen, who is married to actor/writer/producer/director Seth Rogen.
Attendees were told that it was only the second time that the full documentary had been shown, although a very abbreviated version was shown the day before at a NIC Women’s Networking Meetup.
At the gathering of women, Lauren Miller Rogen, who along with her husband is an executive producer of the film, said she’d like to see a program like “Teach for America” or “Community Care Corps” to “get young people who are just out of college, who aren’t sure what they want to do with their lives, give them companion training. …Send them to homes to be companions, to give the primary caregiver a break and really show people that caregiving can be an unbelievable field to go into … and that we can introduce people to the field of caregiving and hopefully continue to elevate it as a really amazing profession for people.”
Companies that hire caregivers should “value that work in higher pay and benefits,” she added.
Lauren Miller Rogen also called for more options “for people to find quality care.”
“There are beautiful places for people to place their loved ones where they can be safe and taken care of, [but] not every place is like that,” she said. “And I think that we need to have conversations around elevating the field of caregiving, paying caregivers more money to attract more people to the field, and to celebrate caregiving as an unbelievable profession that can provide so much to the caregiver and, of course, to other people.”
Certain states have adopted paid family care, she said, adding, “That’s not enough,” and neither are existing programs through Medicaid and Medicare. “We are inching, but it’s not, of course, what is needed, by far,” she said.
Shook said he is “excited” by the Centers for Medicare & Medicaid’s Guiding an Improved Dementia Experience, or GUIDE, program.
“CMS is recognizing that there needs to be a way to compensate people — catch them early on, maybe in their home, maybe somewhere else — who have dementia, and also support them in communities that don’t have memory care expertise, perhaps,” he said.
Shook said that for 15 years, he’s been pitching the idea — “still no takers” — that instead of going to nursing homes, Medicaid funds for care could be given to families via vouchers to spend.
“Forget the license; look at the capability of the party and then let them spend the money there,” he said, adding that families could supplement those funds with their own money.
“They would have other resources that they could afford any one of our senior housing communities — the top tier; any one. It doesn’t take much extra,” he said, adding that families also could use the Medicaid voucher funds for home healthcare.
“It gives them the power, and it opens up the avenues for so many people without the means to be able to serve these people,” Shook said.
